People of the Philippines VS.

Samuel Repollo
CRIMINAL CASE NO. ___________________
HON. ___________________________
RTC-_______________, BRANCH ___
JUDICIAL AFFIDAVIT OF
SAMUEL REPOLLO
I, ___________________, of legal age, married, and living at ___________________, petitioner
in this case, state under oath as follows:
PRELIMINARY STATEMENT
The person examining me is Atty. ___________________ with address at
___________________. The examination is being held at the same address. I am answering his
questions fully conscious that I do so under oath and may face criminal liability for false testimony
and perjury.
PURPOSE: This affidavit/testimony of petitioner ___________________ is being offered to prove
that the respondent ___________________ contracted marriage twice, ___________________
on ___________________, and later with the petitioner ___________________ on
___________________ while the respondents previous marriage with ___________________
was still valid and has not yet legally dissolved. Petitioner will also prove that prior to her marriage
with the respondent she was previously married to ___________________ on
___________________, which marriage was still valid and subsisting at the time she contracted
marriage with the respondent. The petitioners testimony is also offered to prove the legal basis
for the declaration of nullity of the petitioners marriage with the respondent, the same being
bigamous.
1. Q.
A.

Please state your name and other personal circumstances for the record.
___________________.

2.

Q.
A.

Are you the same ___________________, the petitioner in this case?

Yes sir.

3.

Q.
Do you know a certain ___________________?
A. Yes sir. He was the man I married on ___________________.

4. Q.
A.

How did you meet him?

___________________.

5. Q.
Are you still living with ___________________?
A. We have separated since ___________________.
6.

Q.
A.

7. Q.
A.
8.

Q.
A.

Do you have of proof your marriage with ___________________?

Yes sir, I have a marriage contract (Exhibit A).
Do you have children with ___________________?
We have one (1) child namely, ___________________, now ____ years old.
What is the reason for your separation?
The respondents infidelity of and lack of sense responsibility. He was jobless, a
drug addict and did not care to provide the needs of our family. He was dependent on me.

9. Q.
How about a certain ___________________, do you know her?
A.
Yes sir, he was the woman ___________________ previously married on
___________________.
10. Q.
A.

Do you have
___________________?

proof

of

marriage

between

___________________

Yes sir, I have a marriage contract (Exhibit B).

11. Q.
What was the status of the marriage between ___________________ and
___________________ when ___________________ got married to you?

A.

His marriage with ___________________ was still valid and has not yet been
legally dissolved when he married me.

12. Q.
Aside from marriage contracts, do you have other documents to prove the
________________ married ________________ and yourself?
A.
Yes sir, I have a Certification (Exhibit C) from the National Statistics Office
(NSO) showing ___________________s record of having two marriages, to
___________________ and myself.
13. Q.
How about you, do you have previous marriage when you married when you
marry ___________________?
A.
Yes sir, I
___________________.
14. Q.

was

previously

married

to

___________________

on

Do you have proof of your previous marriage with ___________________?

A.

Yes sir, I have a marriage contract (Exhibit D).

15. Q.
Do you have other proof that you are in fact married to ___________________
and to ___________________?
A.

Yes sir, the NSO Certification (Exhibit E).

16. Q.

What was the status of your marriage with ___________________ when you
married ___________________?

A.

___________________ was still alive and my marriage with his was still valid
and has not yet been legally dissolved when I married ___________________.

17. Q.
You are saying that both of you and the respondent have previous marriage at
the time you marry each other?
A.
18. Q.
properties?

Yes sir.
Do you have pre-nuptial agreement with the respondent regarding your

A.

None Sir.

19.

Q.
A.

Do you have common properties with the respondent?

None sir.

20.

Q.
A.

Do you and the respondent have common creditors?

None sir.

IN WITNESS WHEREOF, I have hereunto set my hand this _____ day of ___________
2013 at ___________.
___________________
Affiant

SUBSCRIBED AND SWORN TO BEFORE ME, a notary public in and for

_________(City/Province)____________ this ____th day of ____________ 20___. Affiant
personally came and appeared with _____________(Competent Evidence of Identity)______

issued
by
the
_________(Government
Agency)______
on
___(date)__
at
________(place)_________, bearing his photograph and signature, known to me as the same
person who personally signed the foregoing instrument before me and avowed under penalty of
law to the whole truth of the contents of said instrument.

Doc. No. ____

Page No. ____
Book No. ____
Series of 20__

Atty ___________________________________________
Notary Public
Commission Serial No. ____________________________
Notary Public for _______(Province/City)______________
Until December 31, 20__
Office: ______________(address)____________________
Roll No. __________
IBP Lifetime Roll No. _________; __/__/__ ; _(Province)_
PTR No. _________ ; __/__/__ ; _(Province)_
MCLE Compliance Cert. No. __________; __/__/__

I, ___________________, of legal age, Filipino,

______________________ after being duly sworn depose and say:

with

postal

address

1. I was the one who conducted the examination of witness ___________________ at

my aforementioned office in ___________________;
2. I have faithfully recorded or caused to be recorded the questions I asked and the
corresponding answer that the witness gave;
3. I nor any other person then present or assisting her coached the witness regarding
her answers;
IN WITNESS WHEREOF, I have hereunto set my hand this ____ day of ____ 2013 at
___________.
ATTY. __________________
Affiant

SUBSCRIBED AND SWORN TO BEFORE ME, a notary public in and for

_________(City/Province)____________ this ____th day of ____________ 20___. Affiant
personally came and appeared with _____________(Competent Evidence of Identity)______
issued
by
the
_________(Government
Agency)______
on
___(date)__
at
________(place)_________, bearing his photograph and signature, known to me as the same
person who personally signed the foregoing instrument before me and avowed under penalty of
law to the whole truth of the contents of said instrument.

Doc. No. ____

Page No. ____
Book No. ____
Series of 20__

Atty ___________________________________________
Notary Public
Commission Serial No. ____________________________
Notary Public for _______(Province/City)______________
Until December 31, 20__
Office: ______________(address)____________________
Roll No. __________
IBP Lifetime Roll No. _________; __/__/__ ; _(Province)_
PTR No. _________ ; __/__/__ ; _(Province)_
MCLE Compliance Cert. No. __________; __/__/__

1. The name, age, residence or business address, and occupation of the witness;

2. The name and address of the lawyer who conducts or supervises the examination of the
witness and the place where the examination is being held;
3. A statement that the witness is answering the questions asked of him, fully conscious
that he does so under oath, and that he may face criminal liability for false testimony or
perjury;
4. Questions asked of the witness and his corresponding answers, consecutively
numbered, that:
(i) Show the circumstances under which the witness acquired the facts upon which he
testifies;
(ii) Elicit from him those facts which are relevant to the issues that the case presents; and
(iii) Identify the attached documentary and object evidence and establish their
authenticity in accordance with the Rules of Court;
5. The signature of the witness over his printed name;
6. A jurat with the signature of the notary public who administers the oath or an officer
who is authorized by law to administer the same.
7. Attestation of the lawyer.